[Online consultation] What more should India do to stop smokeless and smoking tobacco use?

CNS Tobacco Control Initiative and Indian Society Against Smoking (ISAS) has launched a time-limited focused online consultation (16-31 July 2011). Dr Mira Aghi's article which is online here makes a strong case why India cannot neglect smokeless tobacco use while strengthening response to controlling smoking forms of tobacco. Guiding question is: What do you think are key measures India can take to improve responses to control all forms of tobacco - smokeless and smoking both?
Kindly send in your comments that will be compiled and sent to the Ministry of Health and Family Welfare in first week of August 2011.

16 comments:

there needs to be stricter implementation of the existing laws which ban smoking in public places and sale of tobacco products within 100 yards of educational institutions, as well as selling of tobacco products to and by minors. There has definitely been a decrease in smoking in public places. But tobacco shops close to schools are still a rule rather than an exception. It is also very easy fro minors to buy cigarettes and other tobacco products. Youngsters, as well as older people can be seen smoking with impunity in some lounges/ hookah bars. Implementation is very halfhearted, to say the least. There is no point in merely promulgating a good law, with scant regards for proper implementation.

We need a law to ban consumption of all forms of chewing tobacco, at least in public places, just like smoking. Chewing tobacco is very popular in all segments of society. Children, women and men are becoming addicted to it in a big way, and often treat it as amouth freshener.It is not only that tobacco sachets/pouches cause environmental pollution, chewing tobacco poses serious and proven health hazards. We need to ban the sale and consumption of all forms of chewing tobacco(gutkha, paan masala,khaini, etc). Let us chew saunf(aniseed),laung(clove)and elaichi(cardamom)instead.

The area I live in, it is so prevalent that people use gul dant manjan which I was shocked to find contains tobacco. Hope there are strict policies to govern such use of tobacco and have clear warnings, strong and powerful on them too,

Tobacco control cannot mean the exact same thing when it comes to programming and policy - in our local context, controlling Gutkha use, regulating its content, helping people (and often children) who deal with its consequences such as mouth-not-opening to name some very early signs, and mobilizing them to quit gutkha chewing - needs a very targetted intervention and not a general one.

Discuss with poor and underprivileged children and you will see how rampant Gutkha chewing is and serious consequences in some of its use.

How are children able to sell and buy Gutkha?

Are we informing children and young enough about dangers of chewing tobacco like Gutkha?

Are we having sensitive programmes to help people who chew tobacco?

Even in hospitals (recently I am sharing my own experience of a private diagnostics and a private super speciality renowned hospital) where staff on duty was smelling of Gutkha use - how is it ethically tolerable for healthcare workers to chew Gutkha but not be allowed to smoke in public or on duty? How is chewing Gutkha less of a sin than smoking on duty?

Spitting has its own consequences and I will be very glad if this can be articulated well in our policy and programmes to control Gutkha in a major way.

Anyone can buy it, minor (children) etc. This is clearly a product that hardly gets under the scanner of public health advocates or policy makers. Why there are no strict rules banning the sale of gul dant manjan to minors, sale by minors, stopping sale of gul dant manjan in general stores (small groceries), why there are no clear strong warnings that not only tobacco kills but this is NOT a good way to clean your teeth! It can cost a lot more in long run!

Tobacco cessation programmes exist in Lucknow, Varanasi etc but most bidi smoking is happening in rural and small towns. How do we hope to help those smoking bidis quit and comply to smokefree policies?

We agree gutkha or Khaini doesn't risk fire accident or smoke-choked filters in aircrafts but given the risk of spitting, bad smell and unhygiene, we must advocate for public health and cleanliness that it is NOT COOL and NOT OKAY to chew tobacco in air travel or train travel or bus travel or shared taxi travel.

Unless we ban or regulate production, sale of PRECURSORS to chewing tobacco like SWEETY SUPARI, "pan masala without tobacco" products or candy cigarettes - it will be very difficult to control smokeless tobacco. Most youth we noticed in university begin chewing supari in their school college years and then it becomes uncool and childish to chew sweety supari (possibly feminine too) and they risk graduating to chewing tobacco... catch them early - keep them away and help them stay away by informing them how dangerous precursor products can be.

Although people are aware that tobacco harms - but - chewing tobacco such as Gutkha or Khaini etc have many other harms to oral health and hygiene (such as sub mucous fibrosis). We should also raise awareness about these hazards that show up much faster than life threatening tobacco related hazards. Children staying on railway stations I noticed some of them can hardly open their mouth due to severe stages of sub mucous fibrosis and possibly other harms.

sweety supari and the likes of it are equally harmful. I wonder if we have ever noticed the dirty water in which supari(areca nut)is kept to soften it before using it in paan. Chewing gutkha, khaini, etc soon becomes an addiction. I think we need some therapeutic chewable replacements to be sold in the market, like saunf , cardamom, clove etc to provide an alternative to those who are hooked on to this lethal poison called chewing tobacco.

No To Tabacco & No To GutkaFirst, I like to congratulate and thanks to Asha Pariwar members,I really appreciate ther work and quite confident reading all the articles publish, update news about Tabacco consumption in India. I am NRI working abroud in Gulf Country but my parents and all family members are in U.P. India. Every time I visit I find consumers increase and shops increase too, We are lacking political will, If our Govenment is sincerly approch to this issue and first banned cheap quality products harmful to public. I think it should start from Politicians public servant first to stop smoking and chew Gutka then come Government servant employees to stop consumption, then only I can see 50% reduction on Tabbaco consuption. Highest consuption of all these products are Uttar Pradesh & Bihar.Need more saminars and presentation by Lap Top on power point by celeberities or well know people or social activist in the week end awareness prograame should take place in the group of 200 people, In my next visit I will contact you guys doing wonderful job. May God bless you all thinking for India, health of Indian citizen as well as keeping environment polution free need to work more for awareness to acheive the goal.